This invention relates generally to medical devices for scraping skin lesions, and more particularly to an improved disposable dermal curette which is particularly effective in the removal of flat lesions or lesions of large area.
A dermal curette is a device used by medical practitioners for scraping growths, such as skin cancers, warts, actinic keratoses and seborrheic keratoses, from the surface of the skin. Generally, such devices are simple in construction, with a handle and a working element having a sharpened edge which is used to scrape the surface of the skin and remove the lesion. The working element is commonly an annular or ring-like configuration providing a curved or circular sharpened edge as the working surface of the curette.
There are generally three basic types of dermal curettes: the Fox Curette, the Piffard Curette and the eye curette. The Fox Curette is a device having a flat handle, usually metallic, with a generally cylindrical arm extending from the handle, also metallic, terminating in a working element having an oval or annular cutting edge. The Piffard Curette has a large metal handle tapering toward the cutting edge inwardly from the end of the handle, with a generally cylindrical metallic arm extending from the handle and terminating in a working element having an oval or rounded-loop cutting edge. The Piffard Curette is further provided with grooves or ribbed surfaces extending longitudinally along the length of the handle of the curette. The eye curette is similar in design to the Fox Curette, but has a working element which is a dish with a sharp edge rather than loop-shaped, resulting in a working edge to provide a scooping action. The eye curette also has grooves or ribbed surfaces which extend circumferentially around the width of the handle.
Variations of the dermal curettes described above are available and are identified and marketed as the Buck, Skeele or Heath curettes. These curettes, as well as the ones described above, are reusable, that is, designed and manufactured for repeated use after sterilization and, when necessary, resharpening.
Dermal curettes of such design have been, and are currently being, used by physicians in medical procedures for the removal of lesions and unhealthy growths from the surface of the skin of a patient. Generally, in such procedures, the physician anesthetizes the area, removes the lesion with a scraping action utilizing a dermal curette, and then cauterizes or electro-desiccates the area scraped. Sometimes the procedure is reversed in part and, after anesthetizing the area, the lesion is desiccated and then scraped using a curette. Ideally, only the lesions or unhealthy growths are removed in the scraping procedure with minimal destruction of the remaining healthy tissues.
As with many medical procedures, the effectiveness of such scraping procedures depends upon two interrelated factors, namely, the skill of the physician and the design of the tool used. Abnormalities of the skin, such as cancers, warts, actinic keratoses and seborrheic keratoses, differ to the touch from healthy tissues. Therefore, the experienced physician relies on the sense of touch during the scraping procedure and xe2x80x9cfeelsxe2x80x9d the difference between healthy and unhealthy tissues. With the proper tools, the physician can use his sense of touch to judge the depth of scraping necessary to remove only the unhealthy tissues, leaving the healthy tissues relatively unharmed.
In view of the sensory-dependent nature of such procedures, the design of the tool used is of critical importance. The curette must have working element which is sharp enough to cut rather than pull and distort the tissue. Reusable curettes, like those described above, dull easily and hold a sharp edge variably. Thus, a curette which has a working element of consistent sharpness, which the disposable curette of the present invention provides because of its one-time use, is needed. Furthermore, the curette should have a handle of sufficient weight to provide the balance necessary to allow the physician to properly xe2x80x9cfeelxe2x80x9d the lesion, and an overall design which provides the physician with maximum control of the tool in use.
In U.S. Pat. No. 5,116,346, which issued in May of 1992, there is described an improved dermal curette which overcomes many of the foregoing disadvantages. The curettes described and claimed in that patent provide proper balance and design to allow a physician to exert the maximum control in scraping lesions from the surface of the patient""s skin. The curettes disclosed there, like most dermal curettes in use today, have an oval or round annular configuration, either in a loop or cup shape. As a result, such curettes are not optimal in the removal of lesions of greater area. Thus there is a need for curettes having a planar cutting edge which may be used effectively in the removal of such large flat lesions. It has been proposed in U.S. Pat. Nos. 4,651,735, 3,934,591, 4,665,915, 4,270,540 and 4,221,222 to employ dermal curettes having a relatively flat cutting surface. Unfortunately, however, most of such curettes and like cutting tools are either not disposable, and hence subject to the disadvantages outlined above, or have removable blades in which the blade is disposable. Nonetheless, such cutting tools do not provide the necessary cutting control and the ability to effectively remove flat lesions with a fewer number of passes and less gouging or formation of grooves in the treated tissue.
It is an object of this invention to provide an improved dermal curette having a substantially flat or planar cutting surface which can be utilized in scraping lesions and growths from the surface of a patient""s skin.
It is another object of this invention to provide an improved dermal curette having a substantially flat or planar working edge of consistent sharpness which is capable of producing a scraping action when used in removing lesions from the surface of a patient""s skin.
It is a further object of this invention to provide an improved dermal curette having a substantially flat cutting surface having the proper balance and design to allow the user maximum control in scraping lesions from the surface of a patient""s skin so that the experienced physician need scrape only to the depth necessary, with minimal gouging or groove formation, while minimizing potentially disfiguring results.
The present invention relates to a disposable dermal curette designed to be used in scraping lesions and unhealthy tissue from the surface of a patent""s skin. The curette includes a generally cylindrical plastic handle having a proximal end portion and a distal end portion, with the proximal end portion tapering inwardly to a point near a flat-nosed end of the handle. The working element which engages the skin is a substantially flattened annular working element attached to the flat-noted end of the handle. Unlike disposable dermal curettes previously employed, the curette of the present invention utilizes a working element having a flattened, substantially planar configuration. The flattened annular thus forms a cutting surface along the base of the working element to scrape lesions and unhealthy tissue from a patient""s skin.
In the most preferred embodiment of the invention, the handle includes a mid-section portion between the proximal and distal end portions. For control and balance, the distal end portion of the handle is provided with a textured surface, preferably grooved or ribbed surfaces, extending longitudinally the distal end portion. The mid-section portion of the handle is preferably defined by a recessed flat surface extending length-wise along the top of the mid-section portion. The remainder of the mid-section portion is generally cylindrical in shape. For maximum control and proper balance, the proximal end portion may further be provided with a textured surface like the distal end portion. The mid-section portion, in one embodiment, may be further provided with a finely textured surface around its width.